Navigating Difficult Conversations in Cosmetic Dermatology

At Dermatology Week APP Day 2025, Beth Haney, DNP, FNP-C, FAANP, FAAN, brought clarity and compassion to the consultation room in her session, “Case-Based Approach to Difficult Conversations in Cosmetic Dermatology.” With over 2 decades of aesthetic experience, Haney delivered practical communication tools for handling common, but emotionally charged, patient interactions.

“These conversations are inevitable,” she said. “But they’re manageable.”

Haney introduced attendees to communication frameworks like the BATHE method for pre-procedure stress screening, the ROAR model for real-time empathy and education during procedures), and the BELLS model for post-procedure complaints. The takeaway? Lead with empathy, communicate clearly, and, above all, listen.

“Believe what the patient is saying,” Haney emphasized. “Don’t dismiss their concerns, even if you can’t see what they see.”

Through relatable case scenarios, she explored some of the trickiest situations aesthetic providers face: patients bringing in filtered celebrity photos, concerns over bruising, disappointment with results, and requests to fix work done elsewhere.

Her advice:

• Set expectations early. Under-promise and over-deliver.
• Normalize healing timelines. Reinforce that neurotoxins take 7–10 days, and filler swelling may take weeks to resolve.
• Avoid knee-jerk corrections. Take time to assess before rushing to dissolve or revise.
• Document and photograph everything.

One powerful moment came as Haney discussed a patient expressing mid-procedure guilt over a disapproving partner. “Pause if needed,” she said. “Make sure their consent is voluntary and self-driven.”

She also urged attendees to screen all new patients for body dysmorphic disorder (BDD) using validated tools like the Cosmetic Procedure Screening Questionnaire or the BDD Questionnaire. While rare, missing the signs could lead to poor outcomes and legal risk.

Haney closed with a reminder that aesthetic medicine isn’t just technical, it’s deeply personal.

“Be honest, be candid, and always center your care around the patient,” she said. “That starts with setting clear expectations and being kind.”

For more meeting coverage, visit the Dermatology Week APP Day newsroom.

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Reference

Haney B. Case-based approach to difficult conversations in cosmetic dermatology. Presented at: Dermatology Week; October 22–25, 2025; Virtual.